Study: Radioactive Seeds Beat Out Other Prostate Cancer Treatments
Brachytherapy May Have Fewer Side Effects, Is Cheaper Than Surgery, External Radiation Therapy
Active Surveillance Also an Option
The researchers did not consider a fourth option: active surveillance. It involves close monitoring of the prostate tumor via tests, digital rectal exams, and intermittent biopsies with the intent of averting treatment unless the cancer progresses.
Active surveillance is a good option for men with smaller or slow-growing tumors or who have other medical conditions that might shorten their life span, Ciezki says. But many men who are good candidates don't choose it because of anxiety -- they feel they have to do something to treat a potentially growing cancer, he says.
Similarly, some men opt for surgery over other treatments because "they want the cancer out of their body," he says.
There are other considerations as well. Not every man is a good candidate for brachytherapy, for example: The cancer has to be confined to the prostate region and the man has to be able to undergo anesthesia, Ciezki says.
Andrew Lee, MD, MPH, a radiation oncologist at the University of Texas M.D. Anderson Cancer Center in Houston, says while the findings deserve more rigorous testing, they are in no way conclusive.
"The SEER-Medicare database offers very limited data, basing outcomes on procedural billing codes. We have no idea whether a patient had a side effect [that was treated with medication] or even whether the procedure is being done in the right setting," he tells WebMD.
Also, the study only looked at the records of patients treated through 2007. A more sophisticated technique of delivering radiation called intensity modulated radiation therapy has basically replaced conventional external radiation therapy over the past 10 years, Lee says.
A second study presented at the news briefing showed that men who get the newer radiation treatment are less likely to experience cancer recurrences or develop serious side effects than those who receive conventional radiation treatment.
Lee also says the side effect rates for all three procedures analyzed in the study are so low that the differences might not mean anything to a patient.
"All three procedures as well as active surveillance are appropriate in the right setting. Discuss the options with your doctor," Lee advises.
These findings were presented at a medical conference. They should be considered preliminary as they have not yet undergone the "peer review" process, in which outside experts scrutinize the data prior to publication in a medical journal.